Basic Information
| Provider Information | |||||||||
| NPI: | 1699793927 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ST. JOSEPH'S HOSPITAL AND HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 7TH ST W | ||||||||
| Address2: | |||||||||
| City: | DICKINSON | ||||||||
| State: | ND | ||||||||
| PostalCode: | 586014335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7014564000 | ||||||||
| FaxNumber: | 7014564800 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 7TH ST W | ||||||||
| Address2: | |||||||||
| City: | DICKINSON | ||||||||
| State: | ND | ||||||||
| PostalCode: | 586014335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7014564000 | ||||||||
| FaxNumber: | 7014564800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 01/30/2008 | ||||||||
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| AuthorizedOfficialLastName: | BISHOP | ||||||||
| AuthorizedOfficialFirstName: | APRIL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP/PATIENT SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 7014564205 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | RN CNA BC | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | 5054A | ND | Y | Hospital Units | Medicare Defined Swing Bed Unit |
No ID Information.